Examples of school attendance to monitor trends

Are there current examples of organizations using school attendance data to monitor trends?

The National Association of School Nurses (NASN) created a data initiative called the National School Health Data Set: Every Student Counts! (Every Student Counts!). This dataset allows for the collection and review of school data that can influence policy, determine best practices for school health, increase advocacy for electronic health records, and help better understand children’s health. Every state is participating in this voluntary initiative at some level. Six districts in four states are piloting a nurse-led surveillance system for school attendance that helps identify students who may be suffering from an undiagnosed health condition such as myalgic encephalomyelitis/chronic fatigue syndrome. This nurse-led surveillance system will allow nurses to better identify chronic health conditions that may become part of Every Student Counts!

Instead of waiting until all states have similar data capacity, NASN meets school nurses where they are and encourages all states to participate in Every Student Counts! regardless of their current data infrastructure. Data point definition documents and data point worksheets help school nurses collect and submit the data. This documentation ensures all states are collecting and submitting comparable data. All data are de-identified and aggregated, but with the switch to a new data platform, school nurses can submit chronic conditions and school attendance data at the school and grade level. Access is restricted on the platform so only authorized individuals can see data by the district and state level. The platform is both HIPAA and FERPA compliant, and participants must attest they are following all state and district data policies before they can gain access. Understanding the importance of school attendance, NASN added it as a data point for the 2020-2021 school year. NASN uses the nationally accepted definition of chronic absence as a student missing ten percent or more of school days during a school year.20

Every Student Counts! provides the tools and resources needed for school nurses to collect, understand, and monitor school data over time to identify trends. Trends and root causes of issues are then shared with the principal and local health department as appropriate. For example, if a school nurse noticed children continuing to leave the classroom for asthma, this could indicate that something else is going on. There have been times where the public health and legal authorities have become involved and identified that a specific housing complex the school serves has mold issues. Collecting the data and forming partnerships with the local health department has allowed issues like this to be addressed quickly so children can remain in school.

This example demonstrates the importance of not waiting for perfect or complete data, because change can occur just by collecting and sharing the data that are currently available. A new platform is making it easier for school nurses to report data to the Every Student Counts! dataset and see how their data compares to other schools like theirs. The initiative provides various training related to data with the understanding that the more work done upfront to help school nurses who have competing priorities, the better the compliance of submitting accurate information to the dataset. While the ultimate goal is to get to individual grade-level data at some point, starting with state or district aggregated data allows for surveillance of data points to recognize a change and implement interventions to improve a child’s health.